Support for Family & Friends

OCD and the Family, Part Iby Cherry Pedrick, RN
Reprinted from Suite101.com,
July
16, 1999, revised

I attended the annual
Obsessive Compulsive Foundation conference in Washington, DC. Every year they have it in a
different part of the country, and this year it was time to have it in the eastern part of
the United States. The best part of this conference is meeting people Ive known only
online. And meeting new people.

We all had one thing in common
 OCD. It is exhilarating to meet people who really know what Im talking about,
people who know what its like to obsess over minor details or feel compelled to
check stuff over and over.

I went out to dinner with
several people from the OCD Internet list Saturday night, then found myself talking with
three friends until 1:00 am. These ladies touched my heart. They dont have OCD,
their sons do. They traveled from Canada, Hawaii and Indiana to learn more about OCD. I am
fascinated by their commitment to helping their loved ones. I love my son and I would do
anything for him. I think I would. But would I be this dedicated?

Talking with my three new
friends I realized their dedication and commitment went beyond the usual loving support.
Like every other family member, they have had to make some difficult choices. It would be
easier to offer reassurance when the person with OCD asks if the door is locked for the
third time. It would be easier to provide a more comfortable environment as the family
members living space becomes smaller and smaller due to perceived contamination.
Over the weekend I gained better insight into the plight of families of people with OCD.

So, with this long
introduction, I would like to discuss OCD as it affects the family. It seems logical to
start by telling family members what they can do to help the person with OCD. How can they
offer support and encouragement? Well get to that, but thats not where
well start. First, Id like to discuss what the role of the person with OCD.
How can we help our family members cope with OCD?

First, try to educate your family members. Print
materials from the Internet, purchase a couple books about OCD. Dont rush the
process. It takes a while to even begin to understand OCD.

Avoid blaming others for OCD. And dont blame
yourself either! It is no ones fault. Its a brain problem that is very
treatable and can be coped with. And you are not your OCD. You are a wonderful person with
great potential. You just happen to have OCD.

Look at ways you involve others in your rituals.
Examples would be: asking your husband to check the door and appliances when you leave the
house; requiring your children to wash their hands excessively; and asking your wife to
launder briefly worn clothes because you feel they are contaminated. List ways you involve
your family in your OCD symptoms and discuss them. Make a plan for stopping these rituals
and ask your family to support you in your effort.

Try not to ask for reassurance. This was my biggest
problem. I"d ask my husband and son questions likeAre you sure I locked the door? I didnt hit that kid on the
bike, did I? and If I touched the counter, then touched the bread, do you
think the sandwich is contaminated? We worked out a deal. They answered the question
one time, then refused to answer again. They might say something like, I cant
answer that again. It wouldnt be helping you.

My OCD was worse when I was under stress or tired.
It helped me to recognize it. It helped my family when I recognized it and warned them.
I'd tell them I needed some extra love and attention and they gave it.

Finally, look at the needs of others. OCD can be so
time-consuming, so overwhelming, that we overlook the difficulties other family members
are dealing with. Make a point of asking about your family members days. Show them
you love them and you appreciate the support they give you. Even if it is minimal support,
praising them for it and showing an interest in their lives will multiply that support.

Coming home from the OCF
conference, I was filled with gratitude for the support and encouragement my family has
given me as Ive struggled with OCD. Take a moment to give your loved ones a hug and
tell them how thankful you are for their love and support.

Note: My book, Loving
Someone with OCD, coauthored with Karen Landsman, Ph.D, offers support and hope for
family members of people struggling with OCD.

OCD and the Family, Part IIby Cherry Pedrick, RN
Reprinted from Suite101.com,
August
17, 1999, revised

I thank God for the support my
family provides as I battle OCD. We tried to stand as one against a common enemy. This
column is devoted to you, the family member. What can you do to help the person with OCD?
You want to help, you want to offer support, but how do you do that?

The first step is education. Read all you can about
OCD. The more you learn, the more you can understand what life with OCD is like. Good
places to start are the links provided here on Suite101. As you learn more about OCD, you
will discover that no one is to blame for your family members illness. OCD
isnt due to improper parenting or trauma. It is a brain problem.

Ask your family member if you can communicate with
the doctors and therapists. If the person consents, ask what your role should be in
assisting with the struggle with OCD.

Talk about OCD and how it is affecting your family.
Give it a name. OCD is the problem, not the sufferer. Find out what kinds of support
groups meet in your area. Ideally, there will be a support group for families of people
with OCD. But probably not. How about a support group for family members of people with
mental illness? Try to get together with people who are dealing with similar difficulties.
There are also support groups and message boards online. The Internet has made the world
much smaller.

Take a look at your relationship with the person
with OCD. List the ways you participate in OCD rituals. Some examples are laundering clean
clothes that the person with OCD insists are contaminated, checking appliances
because the person just cant be sure they are turned off or unplugged, repeating
magical-like phrases to reverse negative things said. By doing these things, you are
enabling the OCD to continue unchecked in your family. It would be extremely difficult to
suddenly stop all participation in OCD rituals. Discuss your list with your family member
and formulate a gradual plan for eliminating your participation in OCD rituals. If your
family member has a therapist, talk with him or her about your plan.

Look especially for ways that you are offering
reassurance. Reassurance-seeking becomes a ritual. This has been a big problem in my
family. When the obsessive thoughts arise, I feel I must check. Even after checking
something, I might still have doubts and I ask my husband or son, Did I lock the
door? Were the cats in the house when we left? We have a rule. They are
to answer my question once, then refuse to offer further reassurance. It makes me angry,
but it does help to break the cycle.

Encourage compliance with the medication treatment. It can take up to 12 weeks for
anti-obsessional medications to work, and then another one might have to be tried if it
doesnt relieve OCD symptoms. Meanwhile, side effects can be difficult to deal with.
Encourage your family member to take the medication as ordered and communicate with the
doctor if side effects are extreme. Compliance with cognitive behavior therapy is
challenging too. Be a cheerleader as your family member struggles to break free from OCD.

Stress exacerbates OCD symptoms. Especially in the beginning of treatment, try to reduce
the stress in the household. Try to keep a structured routine for a while.

And most important  take care of yourself! As
with any illness, caregivers often lose sight of their own health requirements. Be good to
yourself and spend time alone or with friends.

Keep in mind that there is
more to life than OCD. It may be severe at the moment, but there is hope. Offer
encouragement and praise for each step toward breaking free from OCD. And praise yourself
for your part in recovery.

Michael Jenike, MD moderated a
panel discussion about overcoming the stigma of mental illness at the 1999 Obsessive
Compulsive Foundation conference. Special guests were Mike Wallace, William Styron and Art
Buchwald. Life-long friends, they taught us the importance of friends. They had each
experienced clinical depression.

The OCF could not have planned
a better panel discussion. I guess the panel discussed the stigma of mental illness. Like
a good reporter, I had my notebook and pen in hand, ready to write copious notes on the
featured topic. At the end of the hour I looked down to see two sentences on my lavender
paper. (I have a teenage son, also a writer, who steals my paper. He has an aversion to
lavender and pink notebooks, thus my affinity for those colors.)

The first sentence on my
lavender paper was Mike Wallace helped educate his psychiatrist. I could
relate to that! I helped educate my psychiatrist and therapist about OCD. I tried anyway.
Then I wrote articles to help educate my fellow nurses, school teachers and the public.
Then I coauthored The OCD Workbook with Bruce
Hyman, Ph.D., an experienced cognitive-behavioral therapist. Released in October 1999, The OCD Workbook has educated thousands of people
with OCD  and their doctors, therapists and families.

Note: After selling over
40,000 copies, an updated Second Edition of The OCD Workbook was
released in 2005.

The second sentence, and the
point of this column, was Mike Wallace, Bill Styron and Art Buchwald had depression
around the same time. Buchwald called both to offer encouragement. Keep in touch.
Im sure there was more said, questions were asked and the panelists responded. But
the audience took away more than words. These three friends showed us the importance of
friends supporting friends through the difficulties of life, which often includes mental
illness. As they bantered back and forth about who had the worst depression, I could feel
the love and concern they held for each other.

I was impressed with the
honesty they shared with each other  and with us. They could have each kept their
mental illness a secret and missed out on valuable support and friendship. These could
have been fatal secrets!

After much applause, the three
friends stayed a few minutes to shake hands, sign books and pose for pictures. I had
bought Bill Styrons and Art Buchwalds books at the conference book table, but
they were in my room. I went up front and watched the long line of people file by. I took
a couple pictures and chatted with my friends (cyberfriends I normally only get to
see online). I dont need my books signed. The line is too
long. I said.

Then suddenly I wanted more
than a picture of the moment. I raced to the elevator and up to my eighth floor room. I
grabbed the two books and rushed back to the conference room. But I was too late. The
three friends were posing for pictures in front of the side door. I took a couple more
pictures, then they were gone.

The OCF reception followed. We
lined up at the buffet, then sat down to eat pasta, veggies and cheese. I mingled with
people I knew and people I didnt know. After the reception I joined some
cyberfriends for dessert at a local restaurant. It was wonderful to be surrounded by
people who knew what it was like to live with OCD.

I started reading Bill
Styrons Darkness Visible, A Memoir of Madness
on the plane home. He wrote of the support he received from a close friend, a celebrated
newspaper columnist, who had just recovered from manic depression.  . . . and we
were in touch by telephone nearly every day. His support was untiring and priceless. It
was he who kept admonishing me that suicide was unacceptable (he had been
intensely suicidal), and it was also he who made the prospect of going to the hospital
less fearsomely intimidating. I still look back on his concern with immense gratitude. The
help he gave me, he later said, had been a continuing therapy for him, thus demonstrating
that, if nothing else, the disease engenders lasting fellowship.

And in Leaving Home, A Memoir Art Buchwald wrote,
Bill Styron and I had depressions within months of each other. Once we recovered, we
teased each other about whose had been the stronger. I claimed that mine had been a 9.9 on
the Richter scale, and he said that I had suffered nothing more than a rainy day at
Disneyland.

At home, I tried to follow the
example of the three famous friends, Mike Wallace, Bill Styron and Art Buchwald. My
friends dont all have OCD or depression  or any mental illness. But they can
all use support as they deal with lifes problems. And I can certainly use help and
support. Im reminding myself to take Art Buchwalds advice  keep in touch
and offer encouragement. We need each other.

Worried No More - A
Book ReviewBy Cherry Pedrick, RNReprinted from Suite101.com, March 20, 2002, Revised

Worried No More: Help and Hope for Anxious Children by Aureen
Pinto Wagner, Ph.D. will help families develop healthy habits that can help children take
control of anxiety and lead more peaceful, happy lives.

In Worried No More, Dr. Wagner describes the normal anxiety of
childhood and adolescence and the anxiety disorders that may need professional treatment.
After reading this book, parents can more confidently determine if their childs
anxiety is normal and age related or evidence of a deeper problem. Dr. Wagner helps the
parent through the confusing process of seeking help from mental health professionals and
school personnel. Worried No More also addresses school personnel, from a mental
health perspective, giving them much needed advice about educating the anxious child.

One of the difficulties families have when a family member has a
mental illness, or even just excessive anxiety, is guilt. What caused this problem? Who
caused it? Is it my fault? Your fault? Dr. Wagner handles this problem compassionately. No
one can say definitively what caused a particular persons anxiety disorder. Research
is showing that some children have a genetic predisposition toward anxiety. They seem to
inherit a general tendency to being sensitive and emotional, but also fearful and anxious.
Sometimes one or more parent, or another close relative, has an anxiety disorder;
sometimes more than one family member can have an anxiety disorder and not always the same
disorder the child has. Research is also finding differences in brain function and
chemistry in people with anxiety disorders. Life experiences, stress, medical conditions,
and other factors can interact with the genetic predisposition and physical
characteristics to set the stage for anxiety.

So, no one is to blame for anxiety disorders. Were all made a
little different and need to learn different ways to handle the daily stress of life. Dr.
Wagner points out that there is not much that can be done about genetics, temperament or
major life events, but we can affect the factors that perpetuate anxiety. Rather than
worry about the cause of anxiety, she encourages an understanding of the factors that
maintain or fuel anxiety. Then she explains how parents and children can change those
factors using cognitive-behavioral therapy principles.

For parents, chapter 11 is the core of the book. Dr. Wagner provides
specific parenting behaviors that can help children control their anxiety. These are
practical strategies that would help any parent bring up confident and capable children. I
was most impressed with The 3 Ss: Security, Structure and Stability.
Unconditional love, nurturing, and respect build security and help children trust their
parents. This lays a foundation for parental authority and structure. Structure is a
systematic framework of rules, expectations and routines. This in turn provides
dependability and predictability that enhances a childs sense of stability and
security. Feeling safe makes it easier to take chances.

Security, structure and stability means building family habits: rules
that are constant, bedtimes and mealtimes, homework, chores, time spent reading together
and playing games. Most of all, I guess, this all takes planning and some priority
shifting.